Mental Illness Is Not What You Think It Is

I think the most dangerous and potentially harmful inaccuracy of society’s portrayal of mental illness is that it implies that mentally ill people act “randomly” or do things “for no reason.”

There’s this idea, and I see it everywhere, that sanity is binary – you’re either sane, or you’re insane, and the switch can just flip one day and suddenly you’re claiming to be the King of Hungary.

That’s not how mental illness works.

Method and Madness

Mental illness doesn’t suddenly turn your decision-making process from a flowchart into a dice roll. It adds or removes steps on the flowchart, inserts bizarre loops, changes decision branches. It alters the internal logic by which you operate. This can make your decision-making process severely divorced from reality, but there’s still an internal logic there. Decisions are being made based on understandings that, while they may not be accurate to reality, still conform to some sort of structure.

There is, as they say, a method to the madness.

The veteran suffering from PTSD who pulls a gun in a supermarket after something falls off a shelf suddenly isn’t “randomly violent.” That man has, through trauma and stress, come to associate that sort of noise with an immediate and very real threat to his life. Within the bounds of his internal logic, it is entirely rational and reasonable for him to produce a weapon and seek to defend himself.

The problem comes when his internal logic directly conflicts with the external logic of the world. There is no actual threat to his life, and now he’s pulled a weapon and is possibly a threat to other people. We don’t see the reason, only the result, and the result is a man with a gun, ready to defend himself against threats only he can see. The result is frightening.

This is an uncomfortable thing for sane, neurotypical people to have to confront, because it puts a lot less distance between them and the mentally ill. If mental illness is not some fundamental change of state and more of a difference of perspective, then it stands to reason that at some point in the future, their perspective could slide out of alignment with the normal and the rational.

From A Certain Point Of View

For all the fear he causes, the troubled, gun-wielding veteran at least has the one saving grace that people, upon learning that he served in combat, can probably at least begin to understand why he might act that way. People understand enough about the horrors of war to know that it can make people paranoid and hyper-vigilant.

It’s much harder for people to grasp the chain of events that led someone to hold up traffic by dancing naked on an intersection, or why someone has filled their entire house with unopened board games. To many people, it seems so far removed from common understanding that it must be unreasoning, but people don’t do things for no reason. People rarely even do things for what they personally perceive as bad reasons. It may be difficult or impossible to understand their reasoning, but the person dancing naked at the crossroads is doing it because, to them, it seems like the reasonable thing to do.

What can cause such a drastic shift in perspective? It would be comforting, perhaps, to believe that only some earth-shattering trauma like sexual abuse, catastrophic injury or the loss of a loved one could cause it, but the truth is that almost anything can cause a person’s beliefs and behaviours to move outside socially accepted norms.

Take, for instance, bullying. Childhood bullying is now widely accepted as a major cause of mental illness. It stands to reason that repeated physical or emotional abuse could drastically alter your perception of both yourself and others. In some cases, it leads to people who significantly underestimate the value of their appearance or talents, due to having been repeatedly told – and having started to believe – that they are worthless. In other cases it can lead to people who, having seen it work for their tormentors, turn to physical and emotional abuse as a way of getting what they want.

The opposite is also true, of course. Being excessively praised can also cause someone to develop overconfidence and narcissism. If you are told, no matter what you do, that it’s great, you’re eventually going to assume you can do no wrong. Any environment in which a person is judged either too harshly or too leniently can twist their perspective unrealistically.

But as we begin to understand that nearlyanything can cause mental illness, we come to the understanding that interacting with a cold and alienating society that constantly mistreats you is just as believable a cause of mental illness as any other, and probably a more common one.

The Writing on The Wall

The thing is, throughout history, the label “insane” has often been used to describe people whose beliefs and actions differed significantly from the customs and morals of the time.

For a long time after society decided that it was probably unacceptable to just execute homosexuals or throw us in prison for sexual deviancy, they tried to get rid of us by throwing us in mental institutions or chemically castrating us to “treat” our “condition” instead. Although I was lucky enough to have never experienced this personally, I’ve had to contend with people making the accusation that homosexual people have a mental disorder my entire adult life.

Even today, the statistically higher rates of suicide and depression among homosexuals have been used against us, somehow “proving” that we’ve got some kind of mental illness. The fact is, though, that they want to make out as if the depression and suicide is a symptom with homosexuality being the cause, whereas actually, it’s a society full of people who discriminate against homosexuals.

It’s fallen out of vogue – at least somewhat – to call homosexuality a mental disorder. The idea has been too thoroughly debunked by science. However, these exact same tactics that were used against gay men and women for decades are being used against transgender people to this very day, and have been for an equal length of time.

But this isn’t just a historical fact: it’s a metaphor.

A society that alienates you from other people, that marks you apart, that refuses to accept a fundamental aspect of your existence – this is a society that creates mental illness, just as surely as emotional abuse or physical violence. A society that marks people as fundamentally different for displaying the symptoms of mental illness – rather than as people suffering from something that can happen to all of us – takes the position of abuser.